# The ECG shows characteristic ______ changes in V1-V3, with concave ST elevation and peaked T waves in early STEMI.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168401  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

The ECG shows characteristic ______ changes in V1-V3, with concave ST elevation and peaked T waves in early STEMI.

## 보기

1. hyperacute **✔ 정답**
2. chronic
3. subacute
4. progressive
5. evolving

**정답: 1**

## 해설

Hyperacute T-wave changes are early ECG findings in STEMI, occurring within minutes to hours of coronary occlusion. These changes include tall, peaked T waves with a broad base and symmetrical appearance, often seen before the classic ST-segment elevation becomes prominent.

## 임상 시나리오

ECG Changes in STEMI:

1. Hyperacute Phase (0-6 hours)
- Tall, peaked, symmetrical T waves
- Broad-based T waves
- Concave ST elevation
- Most prominent in V1-V3 leads

2. Key ECG Findings Timeline:
- Minutes 0-30: T wave peaking
- Hours 0-6: ST segment elevation
- Hours 6-12: Q wave development
- Hours 12-24: T wave inversion

3. Diagnostic Criteria:
- ST elevation ≥1mm in 2 contiguous leads
- New LBBB
- Reciprocal ST depression
- Posterior MI changes

4. Associated Features:
- J-point elevation
- Loss of R wave progression
- Mirror image changes
- Hyperacute T/QRS ratio >0.36

5. Lead-specific Changes:
- Anterior: V1-V4
- Lateral: I, aVL, V5-V6
- Inferior: II, III, aVF
- Posterior: V7-V9

## 핵심 개념

- **hyperacute** — Occurring very suddenly or at an extremely early stage of a condition, typically within minutes to hours of onset
- **chronic** — Persisting for a long time or constantly recurring, typically lasting for more than three months
- **subacute** — Between acute and chronic phases, developing or occurring gradually over time, typically within weeks
- **progressive** — Developing gradually or in stages, becoming more severe or advanced over time
- **evolving** — Developing or changing gradually over time, showing continuous transformation or development

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